Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 101YM0800X | Counselor | Mental Health | | | No |
| 2 | 251S00000X | Community/Behavioral Health | | | | No |
| 3 | 261QM0801X | Clinic/Center | Mental Health (Including Community Mental Health Center) | | | No |
| 4 | 261QM0850X | Clinic/Center | Adult Mental Health | | | Yes |
| 5 | 261QR0401X | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | | | No |
| 6 | 261QR0405X | Clinic/Center | Rehabilitation, Substance Use Disorder | | | No |
| 7 | 364SP0808X | Clinical Nurse Specialist | Psychiatric/Mental Health | | | No |